Talimogene Laherparepvec (T-VEC) for Breast Cancer Local Recurrence

• Status: Recruiting
• Trial end date: 0000-00-00
• Target enrollment: 35
• Participant gender: Female

Summary

The goal of this clinical research study is to learn if talimogene laherparepvec can help to control recurrent breast cancer. The safety of this drug will also be studied.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: M.D. Anderson Cancer Center
• Collaborator: Amgen
• Last Updated: 2016-08-01

Criteria

Inclusion Criteria:

1. Histological confirmation of breast carcinoma.

2. Histological confirmation of recurrence of chest wall with or without distant metastasis disease.

3. Patients may have any molecular status (ER, PR and HER2) and must have failed at least 1 systemic regimen after their diagnosis of locoregional disease

4. Previous adjuvant endocrine therapy for initial breast cancer was allowed but had to be discontinued at least 1 week before receiving the study drug.

5. Previous chemotherapy for local recurrence is allowed but must have been discontinued at least 4 weeks before receiving the study drug and the patient must have recovered from acute adverse effects.

6. Previous radiation therapy was allowed but must have been discontinued at least 2 months before study drug is administered, and the patient must have recovered from acute toxic effects.

7. Age >=18 years old

8. Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1

9. Adequate hematologic function: 1).Absolute neutrophil count (ANC) >= 1.5x109/L; 2).Platelet count >= 100x109/L; 3).Hemoglobin >=10.0 g/L. 4).International normalization ratio (INR) or prothrombin time (PT) 1.5 x ULN, unless the subject is receiving anticoagulant therapy, in which case PT and partial thromboplastin time (PTT)/ activated PTT (aPTT) must be within therapeutic range of intended use of anticoagulants

10. Adequate renal function: Calculated creatinine clearance > 30 ml/min

11. Adequate Hepatic function: a).Aspartate aminotransferase (AST) <= 2.5 x ULN; b).Alanine aminotransferase (ALT) <= 2.5 x ULN; c).Total bilirubin <= 1.5 x ULN.

12. Subjects must be candidate for intralesional injection into cutaneous, subcutaneous or nodal tumors with or without image ultrasound guidance defined as one or more of the following At least 1 injectable lesion >= 5 mm in longest diameter, multiple injectable lesions that in aggregate have a longest diameter of >=5 mm.

13. Female patients of childbearing potential must have negative urine or serum pregnancy test no more than 3 days prior to starting study treatment.

14. Patients must be able and willing to give written informed consent.

Exclusion Criteria:

1. Patients who have operable disease with curable intent, and/or are candidates for radiation therapy for local control.

2. Patients receiving concurrent anti-cancer therapy (chemotherapy, immunotherapy, radiation therapy, hormonal therapy, and biological therapy) while taking study medication, or have previously received .talimogene laherparepvec or any other oncolytic virus.

3. Patients with metastatic sites that requires chemotherapy and/or non-hormonal targeted therapy.

4. Known active central nervous metastases. Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids >10 mg/day pf prednisone or equivalent

5. More than three lesions per organ for visceral metastases except for lung or lymph node sites.

6. History or evidence of symptomatic autoimmune disease (eg, pneumonitis, glomerulonephritis, vasculitis, or other), or history of active autoimmune disease that has required systemic treatment (ie, use of corticosteroids, immunosuppressive drugs or biological agents used for treatment of autoimmune diseases) in past 2 months prior to enrollment. Replacement therapy (eg, thyroxine for hypothyroidism, insulin for diabetes or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment for autoimmune disease.

7. Patients with concurrent disease or condition that would make them inappropriate for study participation, or any serious medical disorder that would interfere with patients' safety

8. History of a second cancer, except treated basal cell or squamous cell skin cancer, in situ cervical cancer or other cancers for which patients are disease free for at least 3 years.

9. Patients with initial diagnoses of stage IV disease.

10. Patients with active infection and requiring IV or oral antibiotics

11. Evidence of immune suppression due to: a) Known human immunodeficiency virus (HIV) infection or AIDS; b) Known leukemia or lymphoma; c) Those who require high dose steroids or other immunosuppressive agents; d) Known hepatitis B or C infection; e) Congenital or acquired cellular and/or humoral immune deficiency; f) other signs or symptoms of immune system suppression

12. Active herpetic skin lesions or prior complication of HSV-1 infections (e.g. herpetic encephalitis or keratitis).

13. Currently pregnant or breast-feeding, or planning to become pregnant during study treatment and through 3 months after the last dose of study treatment.

14. Female subject of childbearing potential who is unwilling to use acceptable method(s) of effective contraception during study treatment and through 3 months after the last dose of talimogene laherparepvec. (Women of not childbearing potential: post-menopausal [age > 55 years with cessation of menses > 12 months or < 55 years but not spontaneous menses for at least 2 years or < 55 years and spontaneous menses within the past 1 year, but currently amenorrheic (eg, spontaneous or secondary to hysterectomy), and with postmenopausal gonadotropin levels (luteinizing hormone and follicle-stimulating hormone levels > 40 IU/L) or postmenopausal estradiol levels (< 5 ng/dL) or according to the definition of "postmenopausal range" for the laboratory involved] or who have had a hysterectomy, bilateral salpingectomy, or bilateral oophorectomy).

15. Sexually active subjects and their partners unwilling to use male or female latex condom to avoid potential viral transmission during sexual contact while on treatment and within 30 days after treatment with talimogene laherparepvec.

16. Currently enrolled in another clinical trial (exclude non-cancer treatment trail) or received an investigational agent within 4 weeks of study initiation

17. Requires intermittent or chronic treatment with antiherpetic drugs, except for topical agents

18. Patients who is known sensitive to any of the products or components to be administered during treatment with talimogene laherparepvec.

19. Chronic oral or systemic steroid medication use at a dose of >10 mg/d of prednisone or equivalent [steroids with low systemic absorption (e.g. triamcinolone hexacetonide) injected into joint space are allowed]